The chronic prostatitis is a common reproductive system syndrome in young adult men, divided into chronic bacterial prostatitis, non-bacterial prostatitis, prostate pain, of which non-bacterial prostatitis is the most common clinical. The main manifestations are discomfort in urination, white dripping from the urethra, and distension and pain in the lesser abdomen, perineum, and lumbosacral area. It is also known as the “white turbidity” and the “laboring gonorrhea” in Chinese medicine, because the disease is located in the seminal chamber, now also known as “seminal turbidity”.
Causes and Mechanisms
The disease is caused by the lack of restraint in sexual intercourse, failure to fulfill one’s wishes, or withholding sperm from ejaculation, resulting in the delusional movement of the phase fire and the transformation of the detached sperm into white turbidity; or impurity in sexual intercourse, excessive alcohol consumption, internal invasion of dampness and toxicity, congestion of the sperm duct, and stagnation of qi and blood.
For those who work with the brain, the kidney essence is depleted and the phase fire is easily incandescent; for those who have insufficient endowment, the kidney energy is easily injured. If the diet is not careful, the room is overworked, the room is unclean, then the damp heat is easy to take advantage of the deficiency to invade the sperm chamber, so that the sperm chamber can not be closed, the sperm is easy to overflow. If the disease is prolonged and the damp-heat is not clear, coupled with prolonged sitting, resulting in stagnation of qi and blood in the sperm channel, the symptoms are less abdominal, perineum, lumbosacral distension and discomfort.
Clinical manifestations
Some patients have significant symptoms, but there may be no special findings or slight changes in the prostate gland on palpation and prostate fluid examination, while other patients have a large number of pus cells in the prostate fluid and a hardened prostate gland, but may be completely asymptomatic. Therefore, the severity of symptoms may also be related to the patient’s mental factors. Common symptoms are.
Chronic prostatitis is a common reproductive syndrome in young and strong men, divided into chronic bacterial prostatitis, non-bacterial prostatitis, prostate pain, of which non-bacterial prostatitis is the most common clinically. The main manifestations are discomfort in urination, white dripping from the urethra, and distension and pain in the lesser abdomen, perineum, and lumbosacral area. It is also known as the “white turbidity” and the “laboring gonorrhea” in Chinese medicine, because the disease is located in the seminal chamber, now also known as “seminal turbidity”.
Causes and Mechanisms
The disease is caused by the lack of restraint in sexual intercourse, failure to fulfill one’s wishes, or withholding sperm from ejaculation, resulting in the delusional movement of the phase fire and the transformation of the detached sperm into white turbidity; or impurity in sexual intercourse, excessive alcohol consumption, internal invasion of dampness and toxicity, congestion of the sperm duct, and stagnation of qi and blood.
For those who work with the brain, the kidney essence is depleted and the phase fire is easily incandescent; for those who have insufficient endowment, the kidney energy is easily injured. If the diet is not careful, the room is overworked, the room is unclean, then the damp heat is easy to take advantage of the deficiency to invade the sperm chamber, so that the sperm chamber can not be closed, the sperm is easy to overflow. If the disease is prolonged and the damp-heat is not clear, coupled with prolonged sitting, resulting in stagnation of qi and blood in the sperm channel, the symptoms are less abdominal, perineum, lumbosacral distension and discomfort.
Clinical manifestations
Some patients have significant symptoms, but there may be no special findings or slight changes in the prostate gland on palpation and prostate fluid examination, while other patients have a large number of pus cells in the prostate fluid and a hardened prostate gland, but may be completely asymptomatic. Therefore, the severity of symptoms may also be related to the patient’s mental factors. The common symptoms are
1. Abnormal urination
The prostatic ducts open in the posterior urethra, and the disease often coexists with posterior urethritis, resulting in urinary frequency, urgency, painful urination, discomfort in urination, burning sensation in the urethra, incomplete dripping of urine and other symptoms of urinary tract irritation.
2.Local symptoms
Mainly manifested as vague pain and discomfort in the perineum and lower abdomen, pain can be drawn to the lumbosacral region, above the pubic bone and inguinal region.
3.Sexual dysfunction
Premature ejaculation, painful ejaculation, reduced libido or penile erectile dysfunction may occur.
4.General symptoms
The symptoms are fatigue, insomnia, dizziness, and even neuropsychiatric symptoms such as depression and anxiety.
5, rectal finger examination
The size of the prostate gland can be normal or slightly large, both lobes can be asymmetrical, hard or uneven in texture, the central groove is present, and in severe cases the prostate is painful to the touch. The prostate gland is massaged and a specimen of prostate fluid is taken for examination.
Diagnosis and Differential Diagnosis
I. Diagnosis
1. Prostate massage fluid examination Leukocytes are more than 10 per high magnification field, or although less than 10, there are pus cells gathered in heaps and lecithin vesicles are reduced.
2. If necessary, segmental urine and prostatic fluid culture, ultrasound, cystoscopy and other examinations can be performed.
II. Differential diagnosis
l. Chronic canker sores (epididymitis) Occult pain and discomfort in the scrotum and groin, similar to chronic prostatitis. However, in chronic canker sore (epididymitis), nodules can be palpated in the epididymis with mild pressure pain.
2. Seminal vesiculitis Seminal vesiculitis and chronic prostatitis occur together, and in addition to having symptoms similar to prostatitis, they are characterized by hemorrhagic semen and painful ejaculation.
3, prostatic hyperplasia Mostly elderly people develop; frequent nocturnal urination with difficulty in urination and increased residual urine in the bladder; ultrasound and anal finger diagnosis can be used to identify.
Treatment
Comprehensive treatment is advocated, and attention is paid to regulation and care. The clinical treatment is based on the identification of evidence, grasping the three basic pathological aspects of kidney deficiency (the root), damp-heat (the symptoms) and stagnation (the changes); distinguishing the main and secondary aspects and weighing the medicine.
I. Internal treatment
1, the lower jiao damp-heat evidence perineum or less abdominal swelling discomfort, dripping white or with or without, turbid urine, or urinary frequency and urgency, the remaining drainage is incomplete, loose diarrhea; greasy moss, smooth or slippery pulse. Treatment is to clear heat and direct dampness. The formula is Dioscorea Z and Clear Drink. Commonly used drugs such as: Dioscorea Z, Huang Bai, Che Qian Zi, Lian Zi Xin, Fu Ling, Dan Shen, Shi Calamus, etc. Addition and subtraction: if heat is heavier than damp, add raw gardenia, purple grass, scutellaria; if damp is heavier than heat, add raw coix seeds, atractylodes.
2.Dampness and heat accumulate in the evidence of white turbidity at the end of urination or stool, frequent and painful urination, burning sensation in the urethra, or difficulty in urination, pain in the testicles and less abdomen, burning in the anus, wet and itchy scrotum, bitter and sticky mouth; red tongue, yellow and greasy coating, slippery or smooth pulse. The treatment is to clear heat, relieve dampness and detoxify the toxin. The formula is Gentian Diarrhea Liver Soup. Commonly used drugs such as: gentian herb, gardenia, scutellaria, psyllium, zedoary, bupleurum, dampness, etc. Addition and subtraction: if the stool is dry, add raw rhubarb and hedgehog; if urinary tract irritation is obvious, add dandelion, lonicera and amber.
3, Qi stagnation and blood stasis, long duration of the disease, stabbing pain in the perineum and posterior urethra, pain leading to testicles or penis, painful ejaculation, feeling of impurity in urination; dark tongue or petechiae, white or thin yellow coating, string-like pulse. Treatment is to activate blood circulation to remove blood stasis and move Qi to relieve pain. The formula is Shao Abdominal Expulsion of Blood Stasis Soup. Commonly used drugs include: Angelica sinensis, Chuanxiong rhizome, Red peony, Pu huang, Yuan hu, Wu ling fat, cumin, etc. Addition and subtraction: if the pain is obvious, add Wang Bu Liu Xing, San Ling, Curcuma longa; if the drip is more white, add Tu Fu Ling, Dioscorea Z; if the mental symptoms are obvious, add Chai Hu, Dragon Bone, Oyster.
4, yin deficiency fire evidence occasional white turbidity during urination or stool, urethral discomfort, seminal emission or blood sperm, soreness and weakness of the waist and knees, five heartburn, insomnia and dreaminess; red tongue with little bitterness, thin pulse. Treatment is to nourish Yin and lower fire. The formula is Zhi Bai Di Huang Tang. Commonly used drugs such as: Zhi Mu, Huang Bai, Sheng Di, Shan Yao, Ze Di, Fu Ling, Dan Pi, etc. Addition and subtraction: if seminal emission is frequent, add tortoise shell, cherry, gorgonian; if hematuria or hematospermia is seen, add cyperus, dried lotus grass, small thistle, raw pu huang.
5, deficiency of kidney yang is mostly seen in middle-aged and elderly people, with long duration of the disease, dripping urine, mucus flowing from the urethra, soreness and weakness of the waist and knees, impotence and premature ejaculation; cold form and cold limbs; light fat tongue, white coating, sunken pulse. Treatment is to warm Yang and consolidate astringency. The formula is selected from Jisheng Kidney Qi Pill. Commonly used drugs such as: Shu Di, Cornu Cervi Pantotrichum, Yam, Radix et Rhizoma, Cinnamon, Niubizi, Deer Antler Gum, etc. Addition and subtraction: if impotence and premature ejaculation, add Sha Yuan Zi and Cuscuta.
Second, external treatment
(1) Bathing therapy: decoction of Chinese herbal medicine such as onion and sweat swelling soup or warm water bath, 20 minutes each time, twice a day, suitable for those who have already given birth.
(2) navel therapy: musk 0.3 grams, white pepper 7 grains of research, first put the musk in the umbilicus, covered with white pepper powder, then covered with a small white paper, adhesive tape fixed, 7 days to change the medicine once.
Third, other treatments
1. Acupuncture Guan Yuan, Zhong Gu, San Yin Jiao, Chichibian, Yin Ling Quan; add Zhong Ji, Qu Bone, and Si s for damp-heat downward injection; add Kidney Yu, Guan Yuan, and Tai Xi for Kidney Qi deficiency. Daily or once every other day, keep the needle for 15-30 minutes, 10-15 times for a course of treatment.
2.Auricular acupuncture Take Wang Bu Liuxing seeds and apply them with adhesive tape to the kidney, bladder, urethra, subcortical, endocrine and other ear points. Patients should press and knead the points by themselves more than 3 times a day.
3.Skin acupuncture Moderate percussion on both sides of the lumbar to sacral vertebrae and inguinal region.
Prevention and care]
1.Establish confidence to overcome the disease and maintain optimism.
2, moderate sexual life, avoid frequent sexual impulses, abstain from frequent masturbation.
3, abstain from alcohol, avoid eating spicy and stimulating food.
4.Actively participate in physical exercise and outdoor group activities, lead a regular life, do not be sedentary, and avoid long-time bicycle riding and long-distance driving. Urination abnormalities
As a result of inflammation, the prostate gland bruises and retains secretion, causing prostate overflow to drip white at the urethra at the end of urination or during bowel movements as a clinical manifestation. The prostatic ducts open in the posterior urethra, so the disease often coexists with posterior urethritis, resulting in urinary frequency, urgency, painful urination, discomfort in urination, burning sensation in the urethra, incomplete dripping of urine and other symptoms of urinary tract irritation.
5.Local symptoms
Mainly manifested as vague pain and discomfort in the perineum and lower abdomen, pain can be drawn to the lumbosacral region, above the pubic bone and inguinal region.
6.Sexual dysfunction
Premature ejaculation, painful ejaculation, reduced libido or penile erectile dysfunction may occur.
7.General symptoms
The symptoms are fatigue, insomnia, dizziness, and even depression, anxiety and other neuropsychiatric symptoms.
8, rectal finger examination
The size of the prostate gland can be normal or slightly large, both lobes can be asymmetrical, hard or uneven texture, the central groove is present, and in severe cases the prostate is painful to the touch. The prostate gland is massaged at the same time and a specimen of prostate fluid is taken for examination.
Diagnosis and Differential Diagnosis
I. Diagnosis
1. Prostate massage fluid examination Leukocytes are more than 10 per high magnification field, or although less than 10, there are pus cells gathered in heaps and lecithin vesicles are reduced.
2. If necessary, segmental urine and prostatic fluid culture, ultrasound, cystoscopy and other examinations can be performed.
II. Differential diagnosis
l. Chronic canker sores (epididymitis) Occult pain and discomfort in the scrotum and groin, similar to chronic prostatitis. However, in chronic canker sore (epididymitis), nodules can be palpated in the epididymis with mild pressure pain.
2. Seminal vesiculitis Seminal vesiculitis and chronic prostatitis occur together, and in addition to having symptoms similar to prostatitis, they are characterized by hemorrhagic semen and painful ejaculation.
3, prostatic hyperplasia Mostly elderly people develop; frequent nocturnal urination with difficulty in urination and increased residual urine in the bladder; ultrasound and anal finger diagnosis can be used to identify.
Treatment
Comprehensive treatment is advocated, and attention is paid to regulation and care. The clinical treatment is based on the identification of evidence, grasping the three basic pathological aspects of kidney deficiency (the root), damp-heat (the symptoms) and stagnation (the changes); distinguishing the main and secondary aspects and weighing the medicine.
I. Internal treatment
1. Damp-heat in the lower jiao, perineum or abdomen, with or without dripping white, turbid urine, or urinary frequency and urgency, incomplete residual drainage, loose stools and diarrhea; greasy moss, slippery or smooth pulse. Treatment is to clear heat and direct dampness. The formula is Dioscorea Z and Clear Drink. Commonly used drugs such as: Dioscorea Z, Huang Bai, Che Qian Zi, Lian Zi Xin, Fu Ling, Dan Shen, Shi Calamus, etc. Addition and subtraction: if heat is heavier than damp, add raw gardenia, comfrey, scutellaria; if damp is heavier than heat, add raw coix seeds, atractylodes.
2. Dampness and heat accumulation evidence: white turbidity at the end of urination or during stool, frequent and painful urination, burning sensation in the urethra, or difficulty in urination, pain in the testicles and abdomen, burning in the anus, wet and itchy scrotum, bitter and sticky mouth; red tongue, yellow and greasy coating, slippery or smooth pulse. The treatment is to clear heat, relieve dampness and detoxify the toxin. The formula is Gentian Diarrhea Liver Soup. Commonly used drugs such as: gentian herb, gardenia, scutellaria, psyllium, zedoary, bupleurum, dampness, etc. Addition and subtraction: if the stool is dry, add raw rhubarb and hedgehog; if urinary tract irritation is obvious, add dandelion, lonicera and amber.
3. Qi stagnation and blood stasis with long duration, stabbing pain in the perineum and posterior urethra, pain leading to testicles or penis, painful ejaculation, feeling of impurity in urination; dark tongue or petechiae, white or thin yellow coating, and stringent and astringent pulse. Treatment is to activate blood circulation to remove blood stasis and move Qi to relieve pain. The formula is Shao Abdominal Expulsion of Blood Stasis Soup. Commonly used drugs include: Angelica sinensis, Chuanxiong rhizome, Red peony, Pu huang, Yuan hu, Wu ling fat, cumin, etc. Addition and subtraction: if the pain is obvious, add Wang Bu Liu Xing, San Ling, Curcuma longa; if the drip is more white, add Tu Fu Ling, Dioscorea Z; if the mental symptoms are obvious, add Chai Hu, Dragon Bone, Oyster.
4, yin deficiency fire evidence occasional white turbidity during urination or stool, urethral discomfort, seminal emission or blood sperm, soreness and weakness of the waist and knees, five heartburn, insomnia and dreaminess; red tongue with little bitterness, thin pulse. Treatment is to nourish Yin and lower fire. The formula is Zhi Bai Di Huang Tang. Commonly used drugs such as: Zhi Mu, Huang Bai, Sheng Di, Shan Yao, Ze Di, Fu Ling, Dan Pi, etc. Addition and subtraction: if frequent seminal emission is seen, add tortoise shell, cherry, gorgonian; if hematuria or hematospermia is seen, add cyperus, dried lotus grass, small thistle, raw pu huang.
5. Deficiency of kidney yang Most often seen in middle-aged and elderly people, with prolonged illness, dripping urine, mucus flowing from the urethra, soreness and weakness of the waist and knees, impotence and premature ejaculation; cold form and cold limbs; pale fat tongue, white coating, sunken and thin pulse. Treatment is to warm Yang and consolidate astringency. The formula is selected from Jisheng Kidney Qi Pill. Commonly used drugs such as: Shu Di, Cornu Cervi Pantotrichum, Yam, Radix et Rhizoma, Cinnamon, Niubizi, Deer Antler Gum, etc. Addition and subtraction: if impotence and premature ejaculation, add Sha Yuan Zi and Cuscuta.
Second, external treatment
(1) Bathing therapy: decoction of Chinese herbal medicine such as onion and sweat swelling soup or warm water bath, 20 minutes each time, twice a day, suitable for those who have already given birth.
(2) navel therapy: musk 0.3 grams, white pepper 7 grains of research, first put the musk in the umbilicus, covered with white pepper powder, then covered with a small white paper, adhesive tape fixed, 7 days to change the medicine once.
Third, other treatments
1. Acupuncture Guan Yuan, Zhong Gu, San Yin Jiao, Chichibian, Yin Ling Quan; add Zhong Ji, Qu Bone, and Si s for damp-heat downward injection; add Kidney Yu, Guan Yuan, and Tai Xi for Kidney Qi deficiency. Daily or once every other day, keep the needle for 15-30 minutes, 10-15 times for a course of treatment.
2.Auricular acupuncture Take Wang Bu Liuxing seeds and apply them with adhesive tape to the kidney, bladder, urethra, subcortical, endocrine and other ear points. Patients should press and knead the points by themselves more than 3 times a day.
3.Skin acupuncture Moderate percussion on both sides of the lumbar to sacral vertebrae and inguinal region.
Prevention and care]
1.Establish confidence to overcome the disease and maintain optimism.
2, moderate sexual life, avoid frequent sexual impulses, abstain from frequent masturbation.
3, abstain from alcohol, avoid eating spicy and stimulating food.
4, actively participate in physical exercise and outdoor group activities, regular life, do not be sedentary, avoid prolonged cycling and long-distance driving.